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General Pathology > Endocrine I > Flashcards

Endocrine I Flashcards

1
Q

adenohypophysis vs neurohypophysis hormones

A

Adenohypophysis = GH, PRL, ACTH, TSH, gonadotropins

Neurohypophysis = ADH, oxytocin

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2
Q

hormone that stimulates all cells for growth and repair

A

GH

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3
Q

hormone that stimulates production of breast milk

A

prolactin (PRL)

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4
Q

hormone that stimulates adrenal gland to produce cortisol

A

ACTH

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5
Q

hormone that stimulates thyroid to produce thyroxine

A

TSH

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6
Q

hormones that control reproductive functioning and sexual characteristics, stimulate ovaries to produce estrogen and progesterone/testes to produce testosterone and sperm

A

gonadotropins

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7
Q

Neurohypophysis hormones are made in the _______ and transported into _______.

A

hypothalamus / neurosecretory granules

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8
Q

hormone that controls the blood fluid and mineral levels in the body by affecting water retention by the kidneys

A

ADH (vasopressin)

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9
Q

hormone responsible for contractions and breast milk production

A

oxytocin

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10
Q

Name the pituitary gland abnormality: failure or decreased production of GH

A

pituitary dwarfism

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11
Q

Name the pituitary gland abnormality: lack of response to GH

A

pituitary dwarfism

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12
Q

Name the pituitary gland abnormality: short stature, small jaws and teeth

A

pituitary dwarfism

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13
Q

treatment for pituitary dwarfism

A

human growth hormone replacement therapy

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14
Q

benign neoplasm of the anterior pituitary

A

pituitary adenoma

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15
Q

Name the pituitary gland abnormality: circumscribed mass in the sella turcica

A

pituitary adenoma

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16
Q

Pituitary adenomas are more common in _____ between the ages _____.

A

men / 20-50

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17
Q

Two types of pituitary adenomas:

A

macroadenoma

microadenoma

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18
Q

Macroadenoma or microadenoma? large, functioning adenoma

A

macro

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19
Q

Macroadenoma or microadenoma? associated with excess secretion of pituitary hormones

A

macro

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20
Q

Macroadenoma or microadenoma? cause a mass effect due to the size of the lesion

A

macro

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21
Q

Macroadenoma or microadenoma? may impinge on optic chiasm, leads to loss of vision

A

macro

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22
Q

Macroadenoma or microadenoma? invasion of the cavernous sinuses (oculomotor palsies)

A

macro

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23
Q

Macroadenoma or microadenoma? severe headaches

A

macro

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24
Q

Macroadenoma or microadenoma? small, nonfunctioning adenoma

A

micro

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25
Q

Macoradenoma or microadenoma? found in 25% of adult autopsies

A

micro

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26
Q

caused by a GH secreting adenoma that releases hormones as people are growing, so before the closure of the epiphyseal plates

A

gigantism

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27
Q

generalized increase in the size of the body

A

gigantism

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28
Q

disproportionately long arms and legs

A

gigantism

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29
Q

treatment for gigantism

A

surgical removal of the adenoma

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30
Q

due to a pituitary adenoma secreting excess GH after growth is stopped

A

acromegaly

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31
Q

symptoms related to a space occupying mass in the brain: headaches, visual disturbances

A

acromegaly

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32
Q

Excess GH (acromegaly) causes:

A
  • hypertension
  • heart disease (CHF)
  • arthritis
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33
Q

average of 9 years before death

A

acromegaly

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34
Q

Acromegaly

GH is produced after closure of the epiphyseal plates, leads to overgrowth of the bones of:

A
  • membranous bones of the skull and jaw

- small bones of the hands and feet

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35
Q

soft tissues affected by acromegaly

A

 Coarse facial features
 Nose is enlarged
 Hypertrophy of the soft palate

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36
Q

mandibular prognathism (excessive growth of the jaw)

A

acromegaly

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37
Q

anterior open bite

A

acromegaly

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38
Q

may see spacing of the teeth develop

A

acromegaly

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39
Q

treatment for acromegaly

A

removal of the adenoma, radiation therapy

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40
Q

connection of the two lobes of the thyroid gland

A

isthmus

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41
Q

normal weight of the thyroid gland

A

10-30 grams

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42
Q

Describe the follicles of the thyroid gland:

  • Surrounded by?
  • Size?
  • Vascular supply?
  • Epithelium?
  • Contain?
A

o Many small, round globules surrounded by epithelium
o Can vary somewhat in size
o Rich vascular supply
o Follicles are lined by thin, cuboidal epithelium
o Contain thyroglobulin (also called colloid)

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43
Q

follicular or parafollicular cells? stimulated by the release of TSH from the anterior pituitary

A

follicular

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44
Q

follicular or parafollicular cells? convert thyroglobulin into thyroid hormones

A

follicular cells

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45
Q

Thyroid hormones:

A

T4 (90%)

T3

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46
Q

follicular or parafollicular cells? synthesize and secrete calcitonin

A

parafollicular

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47
Q

effects of calcitonin

A
  • promotes the reabsorption of calcium by the skeletal system
  • inhibits resorption of bone by the osteoclasts
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48
Q

6 effects of T3/T4:

A

1) Basal metabolism- increases BMR, body temp, appetite
2) Carbohydrate, lipid, and protein metabolism- promotes glucose catabolism, stimulates protein synthesis, increases lipolysis, enhances cholesterol excretion in bile
3) Reproductive- promotes normal female reproductive ability and lactation
4) Heart- promotes normal cardiac function
5) NS- normal neuronal development in fetus and infants, promotes normal neuronal function in adults, enhances effects of SNS
6) Musculoskeletal- promotes normal body growth and maturation of skeleton, promotes normal function and development of muscles

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49
Q

enlargement of the thyroid

A

goiter

50
Q

Name the thyroid disorder: caused by impaired synthesis of thyroid hormone

A

thyroid goiter

51
Q

Name the thyroid disorder: usually the result of dietary iodine deficiency

A

impaired synthesis of thyroid hormone due to a thyroid goiter

52
Q

Diffuse or multinodular goiter? entire gland is enlarged, but not nodular

A

diffuse

53
Q

Diffuse or multinodular goiter? endemic or sporadic

A

diffuse

54
Q

Endemic or sporadic diffuse goiter? in parts of the world with low iodine

A

endemic

55
Q

Endemic or sporadic diffuse goiter? 10% of the population have a goiter

A

endemic

56
Q

Not enough iodine = not enough ____.

How does the body react?
How does the thyroid react?

What happens?

A

T4

Body releases more TSH, thyroid produces more thyroglobulin

Still can’t make T4 because not enough iodine, so the thyroglobulin accumulates in the follicles (markedly enlarged!)

57
Q

sporadic diffuse goiters occur in which gender

A

females

58
Q

Endemic or sporadic diffuse goiter? puberty/young adults

A

sporadic

59
Q

Endemic or sporadic diffuse goiter? ingestion of substance that interferes with hormone synthesis, hereditary defects in hormone synthesis

A

sporadic

60
Q

Diffuse or multinodular goiter? develops from a long-standing diffuse goiter

A

multinodular

61
Q

Diffuse or multinodular goiter? recurrent episodes of hyperplasia and involution leads to nodular changes

A

multinodular

62
Q

causes the most extreme thyroid enlargement

A

multinodular goiter

63
Q

Diffuse or multinodular goiter? diffusely enlarged thyroid gland, may double in size (still small), nodular

A

multinodular goiter

64
Q

Diffuse or multinodular goiter? histology: follicles are irregularly enlarged, flattened epithelium consistent with inactivity

A

multinodular goiter

65
Q

Name the thyroid disorder: clinical manifestation of thyroid hormone deficiency

A

hypothyroidism

66
Q

Hypothyroidism is the clinical manifestation of thyroid hormone deficiency due to (3) things:

A

1) Defective synthesis of hormone (results in development of a goiter)
2) Inadequate functioning gland due to thyroiditis, surgery, or radioactive iodine therapy
3) Inadequate secretion of TSH by the pituitary

67
Q

most common cause of hypothyroidism in iodine-sufficient areas of the world

A

autoimmune hypothyroidism

68
Q

Hypothyroidism or hyperthyroidism? low T4/T3, elevated TSH

A

hypothyroidism

69
Q

Symptoms of hypothyroidism in older kids/adults:

A

o Tired, sluggish, weight gain, sensitivity to cold
o Mental—difficulty concentrating, memory loss, slowed mentation
o Edema—facial skin, puffy eyelids, hands, feet, and tongue
o Heart—bradycardia, late stages if untreated (edematous, dilated heart, and pericardial effusions)
o Thinning hair, dry skin, constipation

70
Q

another name for congenital hypothyroidism

A

crentinism

71
Q

Congenital hypothyroidism is 2x more common in ______.

A

girls

72
Q

Symptoms of congenital hypothyroidism:

A

 Infants are sluggish, pale, and cold (95 F)
 Impaired development of CNS will result in mental retardation if no treatment
 Short stature due to defects in osseous maturation
 Protruding tongue
 Retained deciduous teeth, failure of permanent teeth to erupt

73
Q

treatment for congenital hypothyroidism

A

 Determine why hormone production is inadequate

 Thyroid replacement hormone

74
Q

another name for hyperthyroidism

A

thyrotoxicosis

75
Q

prolonged secretion of thyroid hormones T4 and T3

A

hyperthyroidism

76
Q

symptoms reflect a hypermetabolic state

A

hyperthyroidism

77
Q

Hyperthyroidism is more common in _____ 7:1.

A

women

78
Q

85% of cases of hyperthyroidism

A

Graves disease

79
Q

most frequent cause of hyperthyroidism is patients under 40

A

Graves disease

80
Q

Name the thyroid disorder: autoimmune disorder causing a diffusely enlarged thyroid gland

A

Graves disease

81
Q

What makes Graves disease an autoimmune disorder?

A

antibodies act as agonists by stimulating the TSH receptor and increasing hormone production

82
Q

Clinical manifestations of Graves disease:

A 
 Diffusely enlarged thyroid gland
 Exophthalmos—CT and muscle volume behind the eye increases 
 Nervousness, tremor 
 Irritability 
 Tachycardia, palpitations 
 Weight loss with increased appetite 
 Night sweats, diarrhea 
 Elevated T4 and T3 
 Depressed TSH
83
Q

CT and muscle volume behind the eye increases

A

exophthalmos (associated with Graves disease)

*usually irreversible

84
Q

Histopathology:
 Overgrowth of glandular epithelium
 Budding of small papillary fronds into what would normally be follicles
 Absence of colloid

A

Graves disease

85
Q

Treatment for Graves disease:

A

 Beta blockers—for tachycardia, palpitations
 Drugs that block hormone synthesis –> Propylthiouracil (PTU)—can cause hepatic failure long term
 Radioactive iodine therapy I131—main side effect is hypothyroidism
 Surgery
 Exophthalmos is usually irreversible—cosmetic surgery

86
Q

massive release of large amounts of thyroid hormone

A

thyroid storm

87
Q

thyroid storm

A

Graves disease

88
Q

Consequences of a thyroid storm:

A

leads to delirium, tachycardia, and elevated temperature

89
Q

mortality rate of thyroid storm

A

20-40%

90
Q

triggers of a thyroid storm

A

infection, psychological trauma, stress, epinephrine injection

91
Q

autoimmune disease that inhibits normal thyroid gland function

A

Hashimoto thyroiditis

92
Q

circulating autoantibodies against thyroglobulin

A

Hashimoto thyroiditis

93
Q

CD8 cells can destroy follicular epithelial cells

A

Hashimoto thyroiditis

94
Q

age/gender of Hashimoto thyroiditis

A

30-40

women > men

95
Q

thyroid shows diffuse, symmetrical enlargement

A

Hashimoto thyroiditis

96
Q

patients become hypothyroid as disease progresses

A

Hashimoto thyroiditis

97
Q

virtually unrecognizable as thyroid

A

Hashimoto thyroiditis

98
Q

Histology:
• Virtually unrecognizable as thyroid
• Numerous collections of lymphocytes
• Formation of lymphoid follicles with germinal centers
• Remaining follicles are small
• Residual epithelial cells are very pink and packed with eosinophilic granules

A

Hashimoto thyroiditis

99
Q

Hurthle cells- damaged, degenerating follicular epithelial cells

A

Hashimoto thyroiditis

100
Q

1.5% of all cancers

A

thyroid carcinomas

101
Q

2 types of thyroid carcinomas:

A

Papillary thyroid carcinoma

Medullary thyroid carcinoma

102
Q

Papillary or medullary thyroid carcinoma? most common thyroid carcinoma—85% of all cases

A

papillary

103
Q

Papillary or medullary thyroid carcinoma? common in patients with exposure to ionizing radiation (atomic bomb survivors, nuclear accidents, diagnostic or therapeutic radiation to the neck)

A

papillary

104
Q

Papillary or medullary thyroid carcinoma? often arise in females, 25-50

A

papillary

105
Q

Papillary or medullary thyroid carcinoma? asymmetrical, painless enlargement of the thyroid gland

A

papillary

106
Q

Papillary or medullary thyroid carcinoma? tumor mass may or may not appear to be encapsulated

A

papillary

107
Q

Papillary or medullary thyroid carcinoma? good prognosis: 10-year survival > 95%

A

papillary

108
Q

5-15% of all cases of papillary thyroid carcinomas

A

follicular carcinomas

109
Q

Papillary or medullary thyroid carcinoma? can be multifocal because frequently invades lymphatics within thyroid

A

papillary

110
Q

Papillary or medullary thyroid carcinoma? may see lymph node metastases in 1/4 if cases

A

papillary

111
Q

Papillary or medullary thyroid carcinoma? fronds of epithelium within thin cores of fibrovascular tissue

A

papillary

112
Q

Papillary or medullary thyroid carcinoma? fronds have a papillary pattern

A

papillary

113
Q

All papillary neoplasms should be considered _______.

A

malignant

114
Q

Papillary or medullary thyroid carcinoma? papillary growth and “empty” appearing nuclei

A

papillary

115
Q

Papillary or medullary thyroid carcinoma? develop from the parafollicular “C” cells, excess secretion of calcitonin

A

medullary

116
Q

Papillary or medullary thyroid carcinoma? ~5% of thyroid cancers, but very aggressive

A

medullary

117
Q

Papillary or medullary thyroid carcinoma? 70% arise sporadically

A

medullary

118
Q

Papillary or medullary thyroid carcinoma? familial form develops in patients with multiple endocrine neoplasia (MEN) type 2A or 2B

A

medullary

119
Q

Patients with a familial form of medullary thyroid carcinoma may initially present with:

A

 Multiple mucosal neuromas of the oral cavity and eyelids
 You may be the first to diagnose it—before cancer
 Patients receive prophylactic thyroidectomy

120
Q

patients receive prophylactic thyroidectomy

A

MEN type 2A or 2B

General Pathology (11 decks)

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